Characteristics, Outcomes, and Prognostic Indicators of Fall-Related Open Globe Injuries

Emami-Naeini, Parisa; Ragam, Ashwinee; Bauza, Alain; Soni, Nishant; Langer, Paul D.; Zarbin, Marco A.; Bhagat, Neelakshi

doi:10.1097/iae.0b013e31828abe50

Cited by 20 publications

(34 citation statements)

References 21 publications

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“…This rate was reported to be 20.1 to 100% in severe OGIs in the literature. 5,7,8,10,13,14 Hyphema was a prognostic factor for poor final VA (P = 0.009) in our study. Rofail et al 3 reported hyphema was a predictor of poorer visual outcome.…”

Section: Discussionsupporting

confidence: 52%

“…8 However, some studies found no association between vitreous hemorrhage and visual outcome. 6,13,14 Feng et al 10 considered that severe intraocular hemorrhage was not only a predictor of an unfavorable outcome, but also a reflection of the seriousness of the ocular damage, which includes severe intraocular tissue injury, such as to the choroid and retina. In our study, retinal detachment was detected in 40.9% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…1 A globe rupture is a type of OGI caused by blunt ocular trauma and has poor visual outcome. 2 Several studies have suggested that the factors that significantly predict visual outcome after OGIs are presenting visual acuity (VA), [3][4][5][6] presence of a relative afferent pupillary defect (RAPD), 3,7-9 mechanism of injury, 4,6,7,10,11 wound location, 8,10,[12][13][14] wound size and extension, 10,11,15,16 adnexal trauma, 7,9,12,17 lens damage, 4,11 hyphema, 3,11 vitreous hemorrhage, 3,4,8,10,12 and retinal detachment. 4,5,7,12,17 The major signs of scleral rupture are VA with light perception or less, conjunctival edema and subconjunctival hemorrhage, hyphema, ocular hypotony, impairment or dislocation of the lens, vitreous hemorrhage, and retinal detachment.…”

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics and prognostic factors of scleral rupture due to blunt ocular trauma

Yücel

Demir

Niyaz

et al. 2016

Eye

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PurposeTo describe and identify ocular and wound characteristics, and prognostic factors associated with final visual acuity (VA) in patients with scleral rupture due to blunt ocular trauma.MethodsThe medical records of 61 patients with globe rupture due to blunt ocular trauma who underwent primary repair were reviewed retrospectively. The data recorded included demographic characteristics, initial and final VA, ocular signs, wound characteristics, and surgeries. Initial VA, ocular signs, wound characteristics, and surgeries were analyzed to determine the association with the final VA.ResultsForty three women and 18 men with a mean age of 43.6±23.5 years were included in the study. The locations of scleral wounds were mostly in the superonasal quadrant (41.0%) and zone 2 (75.4%). In eyes with hyphema (P=0.009), vitreous hemorrhage (P=0.001), and retinal detachment (P=0.004), final VA was statistically worse than eyes without these signs. A moderate positive correlation was found between the initial and final VA (P<0.001). Final VA was statistically worse in eyes with horizontal midline wounds than in eyes with vertical midline wounds (P=0.002). A moderate negative correlation was found between scleral wound length and final VA (P<0.001). Patients who underwent cataract surgery had statistically better final VA (P=0.002).ConclusionsScleral rupture was detected mostly in females, superonasal quadrant and zone 2. Poor final VA was significantly associated with poor initial VA, longer wound length, horizontal midline wound, presence of hyphema, vitreous hemorrhage and retinal detachment at presentation, and cataract surgery not performed during follow-up period. Scleral ruptures have different demographic, ocular and wound characteristics than other open globe injuries.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics and prognostic factors of scleral rupture due to blunt ocular trauma

Yücel

Demir

Niyaz

et al. 2016

Eye

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“…[8][9][10] Fall-related open globe injuries are seen in women and elderly patients more frequently. [9][10][11][12] It was reported that 14% of open globe injuries are related with falling and 64 % of the all patients were 65-year-old and older. 11 There are many studies about eye injuries that had occured days or many years after extracapsular cataract surgery (ECCE) and IOL implantation.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11][12] It was reported that 14% of open globe injuries are related with falling and 64 % of the all patients were 65-year-old and older. 11 There are many studies about eye injuries that had occured days or many years after extracapsular cataract surgery (ECCE) and IOL implantation. 12 Kloek et al reported that 7% of open globe injuries were because of dehiscence of cataract wound; and 89% of these injuries were in patients that had cataract surgery by ECCE.…”

Section: Discussionmentioning

confidence: 99%

Scleral Tunnel Rupture Following Trauma 12 Years After Small Incision Cataract Surgery: Case Report

Kıvanç¹,

Budak²,

Özmen³

et al. 2017

Turkiye Klinikleri J Ophthalmol

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ound sealing has been shown to be more secure in scleral tunnel incision than in clear corneal incision for cataract surgery. In addition, intraocular pressure was found to be more stable in immediate period after scleral tunnel incision than clear corneal incision despite wound hydration is not performed in scleral tunnel incision.1 However, in case of trauma, scleral tunnel integrity may be disrupted in late period after cataract surgery and serious ocular complications may occur. In literature, scleral tunnel rupture following trauma five years after manual small incision cataract surgery with subconjunctival IOL dislocation through the tunnel was reported. 2 We describe herein a case who had scleral tunnel rupture and IOL dislocation through the tunnel following ocular trauma Case Report A AB BS S T TR RA AC CT T It has been shown that scleral tunnel incision is more secure than corneal incision in terms of wound sealing in cataract surgery. After trauma, scleral tunnel integrity may be disrupted long time after cataract surgery. We report herein a 75 year-old woman, that was referred to our department of ophthalmology with loss of vision and hemorrhagic discharge in her right eye following ocular trauma in a traffic accident. The visual acuity of the right eye was light perception and slit lamp biomicroscopy revealed diffuse subconjunctival hemorrhage, chemosis and total hyphema. She had scleral tunnel rupture and intraocular lens dislocation through the tunnel following ocular trauma. She had undergone cataract surgery and intraocular lens implantation by mini-nucleus technique 12 years ago.K Ke ey yw wo or rd ds s: : Cataract; sclera; wounds and injuries Ö ÖZ ZE ET T Katarakt cerrahisinde, skleral tünel insizyonunun yara yeri sızdırmazlığı açısından korneal insizyondan daha güvenilir olduğu gösterilmiştir. Travmayı takiben, katarakt cerrahisinden uzun zaman sonra skleral tünel bütünlüğü bozulabilir. Biz, bu yazıda trafik kazası sonucu okü-ler travmayı takiben görme azlığı ve gözden kanlı akıntı gelmesi şikayeti ile kliniğimize başvu-ran 75 yaşındaki bir kadın hastayı bildirdik. Sağ gözde görme keskinliği ışık hissi seviyesinde idi ve biyomikroskobik muayenesinde yaygın konjunktiva altı hemoraji, kemozis ve total hifeması izlendi. Oküler travmayı takiben skleral tünel rüptürü ve skleral tünelden göz içi lens dislokasyonu mevcuttu. On iki yıl önce mini nükleus tekniğiyle katarakt cerrahisi ve göz içi lens implantasyonu yapılmıştı.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Katarakt; sklera; yaralar ve yaralanmalar

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Severe cranial neuropathies caused by falls from heights in children

Zahavi

Luckman

Yassur

et al. 2015

Graefes Arch Clin Exp Ophthalmol

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Characteristics, Outcomes, and Prognostic Indicators of Fall-Related Open Globe Injuries

Abstract: Fall-related OG injuries can lead to severe ocular morbidity especially in the elderly patients. They carry a worse visual prognosis compared with other injuries, which emphasizes on the importance of protective measures in this population.

Cited by 20 publications

References 21 publications

Clinical characteristics and prognostic factors of scleral rupture due to blunt ocular trauma

Clinical characteristics and prognostic factors of scleral rupture due to blunt ocular trauma

Scleral Tunnel Rupture Following Trauma 12 Years After Small Incision Cataract Surgery: Case Report

Severe cranial neuropathies caused by falls from heights in children

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